Search results for: lean methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15068

Search results for: lean methods

5018 Psychological Alarm among Individuals Suffering from Irritable Bowel Syndrome

Authors: Selim A., Albasher N., Bakrmom G., Alanzi S.

Abstract:

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by abdominal discomfort or pain and associated with alteration in frequency and/or form of bowel habit among other symptoms. This diagnosis is associated with increased levels of psychological distress, maladaptive coping, genetic risk factors, abnormal small and colonic intestine transit, change in stool frequency or form and abdominal discomfort or pain. Aim: The aim of the study was to assess psychological alarm among individuals suffering from Irritable Bowel Syndrome (IBS). Methods: A cross-sectional correlational research design was used to conduct the current study. A convenience sample of 504 participants was included in the present study. Data were collected using a self-report questionnaire. The questionnaire included socio-demographic data, ROME III to identify Irritable Bowel Syndrome (IBS) and Psychological Alarm Questionnaire. Results: Out of 504 participants who reported abdominal discomfort, 297 (58.9 %) participants met the diagnostic criteria of IBS. The mean age of the IBS participants was 30.16 years, females composed 75.1% of the IBS participants, and 55.2% did not seek medical help. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals when compared to individuals not suffering from IBS. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals compared to individuals not suffering from IBS. Conclusion: IBS is highly associated with significant psychological alarms including depression, anxiety and suicidal ideas.

Keywords: abdominal pain , irritable bowel syndrome, distress, psychological alarms

Procedia PDF Downloads 174
5017 Engineering Ligand-Free Biodegradable-Based Nanoparticles for Cell Attachment and Growth

Authors: Simone F. Medeiros, Isabela F. Santos, Rodolfo M. Moraes, Jaspreet K. Kular, Marcus A. Johns, Ram Sharma, Amilton M. Santos

Abstract:

Tissue engineering aims to develop alternatives to treat damaged tissues by promoting their regeneration. Its basic principle is to place cells on a scaffold capable of promoting cell functions, and for this purpose, polymeric nanoparticles have been successfully used due to the ability of some macro chains to mimic the extracellular matrix and influence cell functions. In general, nanoparticles require surface chemical modification to achieve cell adhesion, and recent advances in their synthesis include methods for modifying the ligand density and distribution onto nanoparticles surface. However, this work reports the development of biodegradable polymeric nanoparticles capable of promoting cellular adhesion without any surface chemical modification by ligands. Biocompatible and biodegradable nanoparticles based on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBHV) were synthesized by solvent evaporation method. The produced nanoparticles were small in size (85 and 125 nm) and colloidally stable against time in aqueous solution. Morphology evaluation showed their spherical shape with small polydispersity. Human osteoblast-like cells (MG63) were cultured in the presence of PHBHV nanoparticles, and growth kinetics were compared to those grown on tissue culture polystyrene (TCPS). Cell attachment on non-tissue culture polystyrene (non-TCPS) pre-coated with nanoparticles was assessed and compared to attachment on TCPS. These findings reveal the potential of PHBHV nanoparticles for cell adhesion and growth, without requiring a matrix ligand to support cells, to be used as scaffolds, in tissue engineering applications.

Keywords: tissue engineering, PHBHV, stem cells, cellular attachment

Procedia PDF Downloads 197
5016 Exploring the Development of Communicative Skills in English Teaching Students: A Phenomenological Study During Online Instruction

Authors: Estephanie S. López Contreras, Vicente Aranda Palacios, Daniela Flores Silva, Felipe Oliveros Olivares, Romina Riquelme Escobedo, Iñaki Westerhout Usabiaga

Abstract:

This research explored whether the context of online instruction has influenced the development of first-year English-teaching students' communication skills, being these speaking and listening. The theoretical basis finds its niche in the need to bridge the gap in knowledge about the Chilean online educational context and the development of English communicative skills. An interpretative paradigm and a phenomenological design were implemented in this study. Twenty- two first-year students and two teachers from an English teaching training program participated in the study. The students' ages ranged from 18 to 26 years of age, and the teachers' years of experience ranged from 5 to 13 years in the program. For data collection purposes, semi- structured interviews were applied to both students and teachers. Interview questions were based on the initial conceptualization of the central phenomenon. Observations, field notes, and focus groups with the students are also part of the data collection process. Data analysis considered two-cycle methods. The first included descriptive coding for field notes, initial coding for interviews, and creating a codebook. The second cycle included axial coding for both field notes and interviews. After data analysis, the findings show that students perceived online classes as instances in which active communication cannot always occur. In addition, changes made to the curricula as a consequence of the COVID-19 pandemic have affected students' speaking and listening skills.

Keywords: attitudes, communicative skills, EFL teaching training program, online instruction, and perceptions

Procedia PDF Downloads 108
5015 Postprandial Glycemic and Appetite Responses of Muffins Supplemented with Different Vegetables in Young Males

Authors: Muhammad Umair Arshad

Abstract:

Background and Objectives: Different vegetables have been reported to possess diabetic potential in in-vitro studies; however, the same role of these vegetables has not been much explored through human intervention. Therefore, the present study was conducted to examine the comparative effects of muffins supplemented with bitter gourd (BGM), and other vegetables like spinach (SPM) and eggplant (EPM) on subjective appetite, blood glucose (BG), gut hormones and food intake in healthy young males through a randomized, cross over experiment. Methods and Study Design: After 12 hours fasting, twenty-four healthy young males (18-30 Y) were fed 250ml of plain muffins (control) or supplemented with bitter gourd powder, BGM (10g/100g flour), or spinach powder, SPM (10g/100g flour), or eggplant powder, EPM (10g/100g flour). An ad libitum pizza meal was served at 120min to measure the food intake. Subjective appetite, blood glucose, and gut hormones (insulin, GLP-1, active ghrelin) were measured at intervals from baseline to 120min. Results: Post-treatment (0-120min) glucose, but not insulin, decreased following all the vegetables supplemented muffins compared to the control (p < 0.0001) with a more pronounced effect of BGM. However, post-treatment avg. subjective appetite (p=0.0017) and food intake (p=0.0021) were reduced following BGM but not SPM and EPM. BGM further improved GLP-1 concentration (p < 0.0001), and reduced active ghrelin (p=0.0022), compared with control. Conclusions: The bitter gourd supplemented baked foods possess potential more than other vegetables to regulate postprandial appetite and glycemic responses, without a disproportionate increase in insulin concentration.

Keywords: vegetables, muffins, glucose homeostasis, subjective appetite, food intake

Procedia PDF Downloads 95
5014 The Effect of Extracts of 12 Local Medicinal Plants Against Uropathogenic Escherichia Coli

Authors: Hafida Merzouk

Abstract:

Urinary tract infections are among the most serious public health issues in all age groups. Thus, the empirical therapy should based on local levels of resistance, as indicated in several studies from different countries, to effectively avoid the emergence of multidrug-resistant bacterial strains and recurrent infections. Numerous effective antibiotic treatments are available, but wouldbe ineffective for treating recurrent cystitis caused by a urinary tract infection, as well as the emergence of drug resistance. That iswhy the aim of this study was to highlight the antibacterial and the antioxidant activity of 11 medicinal plants used traditionally in Algeria against E. coli, the most responsible urinary tract infections. First, the extraction of total polyphenols with aqueous acetone showed variable yields. The highest yield was obtained by Asplenium trichomanes with 27%, followed by Petroselinum crispum and Ciannamomum cassia with an equal yield of 21%. Artemisia herba-alba gave the lowest yield (9%). The extracts of different plants showed variable contents of phenolic compounds. Reducing power and DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging activity revealed that most of the extracts studied had significant activity. The anti-free radical activity was very high in the extract of A splenium adiantum-nigrum compared with the other extracts studied, but Petroselinum crispum and Parietaria officinalis had the lowest reducing activity; Antibacterial activity was determined on E. coli strainsusing the diffusion, MICs (Minimum Inhibitory Concentrations) and MBCs (Minimum Bactericidal concentrations) methods. The strains tested were sensitive to most extracts studied, except Asplenium adiantum-nigrum extract, for which both strains showed resistance.

Keywords: E. coli, medicinal plants, phenolic compounds, urinary infections

Procedia PDF Downloads 46
5013 Structured Access Control Mechanism for Mesh-based P2P Live Streaming Systems

Authors: Chuan-Ching Sue, Kai-Chun Chuang

Abstract:

Peer-to-Peer (P2P) live streaming systems still suffer a challenge when thousands of new peers want to join into the system in a short time, called flash crowd, and most of new peers suffer long start-up delay. Recent studies have proposed a slot-based user access control mechanism, which periodically determines a certain number of new peers to enter the system, and a user batch join mechanism, which divides new peers into several tree structures with fixed tree size. However, the slot-based user access control mechanism is difficult for accurately determining the optimal time slot length, and the user batch join mechanism is hard for determining the optimal tree size. In this paper, we propose a structured access control (SAC) mechanism, which constructs new peers to a multi-layer mesh structure. The SAC mechanism constructs new peer connections layer by layer to replace periodical access control, and determines the number of peers in each layer according to the system’s remaining upload bandwidth and average video rate. Furthermore, we propose an analytical model to represent the behavior of the system growth if the system can utilize the upload bandwidth efficiently. The analytical result has shown the similar trend in system growth as the SAC mechanism. Additionally, the extensive simulation is conducted to show the SAC mechanism outperforms two previously proposed methods in terms of system growth and start-up delay.

Keywords: peer-to-peer, live video streaming system, flash crowd, start-up delay, access control

Procedia PDF Downloads 306
5012 An Exploratory Investigation into the Quality of Life of People with Multi-Drug Resistant Pulmonary Tuberculosis (MDR-PTB) Using the ICF Core Sets: A Preliminary Investigation

Authors: Shamila Manie, Soraya Maart, Ayesha Osman

Abstract:

Introduction: People diagnosed with multidrug resistant pulmonary tuberculosis (MDR-PTB) is subjected to prolonged hospitalization in South Africa. It has thus become essential for research to shift its focus from a purely medical approach, but to include social and environmental factors when looking at the impact of the disease on those affected. Aim: To explore the factors affecting individuals with multi-drug resistant pulmonary tuberculosis during long-term hospitalization using the comprehensive ICF core-sets for obstructive pulmonary disease (OPD) and cardiopulmonary (CPR) conditions at Brooklyn Chest Hospital (BCH). Methods: A quantitative descriptive, cross-sectional study design was utilized. A convenient sample of 19 adults at Brooklyn Chest Hospital were interviewed. Results: Most participants reported a decrease in exercise tolerance levels (b455: n=11). However it did not limit participation. Participants reported that a lack of privacy in the environment (e155) was a barrier to health. The presence of health professionals (e355) and the provision of skills development services (e585) are facilitators to health and well-being. No differences exist in the functional ability of HIV positive and negative participants in this sample. Conclusion: The ICF Core Sets appeared valid in identifying the barriers and facilitators experienced by individuals with MDR-PTB admitted to BCH. The hospital environment must be improved to add to the QoL of those admitted, especially improving privacy within the wards. Although the social grant is seen as a facilitator, greater emphasis must be placed on preparing individuals to be economically active in the labour for when they are discharged.

Keywords: multidrug resistant tuberculosis, MDR ICF core sets, health-related quality of life (HRQoL), hospitalization

Procedia PDF Downloads 331
5011 Effect of Correlation of Random Variables on Structural Reliability Index

Authors: Agnieszka Dudzik

Abstract:

The problem of correlation between random variables in the structural reliability analysis has been extensively discussed in literature on the subject. The cases taken under consideration were usually related to correlation between random variables from one side of ultimate limit state: correlation between particular loads applied on structure or correlation between resistance of particular members of a structure as a system. It has been proved that positive correlation between these random variables reduces the reliability of structure and increases the probability of failure. In the paper, the problem of correlation between random variables from both side of the limit state equation will be taken under consideration. The simplest case where these random variables are of the normal distributions will be concerned. The case when a degree of that correlation is described by the covariance or the coefficient of correlation will be used. Special attention will be paid on questions: how much that correlation changes the reliability level and can it be ignored. In reliability analysis will be used well-known methods for assessment of the failure probability: based on the Hasofer-Lind reliability index and Monte Carlo method adapted to the problem of correlation. The main purpose of this work will be a presentation how correlation of random variables influence on reliability index of steel bar structures. Structural design parameters will be defined as deterministic values and random variables. The latter will be correlated. The criterion of structural failure will be expressed by limit functions related to the ultimate and serviceability limit state. In the description of random variables will be used only for the normal distribution. Sensitivity of reliability index to the random variables will be defined. If the reliability index sensitivity due to the random variable X will be low when compared with other variables, it can be stated that the impact of this variable on failure probability is small. Therefore, in successive computations, it can be treated as a deterministic parameter. Sensitivity analysis leads to simplify the description of the mathematical model, determine the new limit functions and values of the Hasofer-Lind reliability index. In the examples, the NUMPRESS software will be used in the reliability analysis.

Keywords: correlation of random variables, reliability index, sensitivity of reliability index, steel structure

Procedia PDF Downloads 223
5010 Rituximab Therapy for Musculoskeletal Involvement in Systemic Sclerosis

Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

Abstract:

Objectives. There is very few data on changes of the musculoskeletal manifestations (artritis, arthralgia, muscle weakness, etc.) in systemic sclerosis (SSc) on rituximab (RTX) therapy. The aim of our study was to assess the severity of the musculoskeletal involvement in SSc patients (pts) and its changes during RTX therapy. Methods. Our study included 103 pts with SSc. The mean followup period was 12.6±10.7 months. The mean age was 47±12.9 years, female-87 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had interstitial lung disease (ILD) and were positive for ANA, 67% of them were positive for antitopoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. Arthritis was observed in 22 pts (21%), arthralgias in 47 pts (46%). Muscle weakness was observed in 17 pts (17%). Tendon friction rubs was established in 7 pts (7%). The results at baseline and at the end of the follow up are presented in the form of mean values. Results. There was an improvement of all outcome parameters and musculoskeletal manifestations on RTX therapy. There was a decrease in the number of pts with arthritis from 22 (21%) to 10 (9%), a decrease in the number of pts with arthralgias from 47 (46%) to 31 (30%). The number of pts with muscle weakness decreased from 17 (17%) to 7 (7%). The number of pts with tendon friction rubs decreased from 7 (7%) to 3 (3%). The creatine phosphokinase decreased from 365.5±186 to 70.8±50.4 (p=0.00006). The C-reactive protein (CRP) decreased from 23.2±31.3 to 8.62±7.4 (p=0.001). The dose of prednisolone was reduced from 11.3±4.5 to 9.8±3.5 mg/day (p=0.0004). Conclusion. In our study, musculoskeletal involvement was detected in almost half of the patients with SSc-ILD. There was an improvement of musculoskeletal manifestations despite a small cumulative dose of RTX. We also managed to reduce the dose of glucocorticosteroids. The improvement of musculoskeletal manifestations was accompanied by a decrease in laboratory parameters - creatine phosphokinase and CRP. RTX is effective option for treatment of musculoskeletal manifestations in SSc.

Keywords: arthritis, musculoskeletal involvement, systemic sclerosis, rituximab

Procedia PDF Downloads 67
5009 Effect Of Shading In Evaporatively Cooled Greenhouses In The Mediterranean Region

Authors: Nikolaos Katsoulas, Sofia Faliagka, Athanasios Sapounas

Abstract:

Greenhouse ventilation is an effective way to remove the extra heat from the greenhouse through air exchange between inside and outside when outside air temperature is lower. However, in the Mediterranean areas during summer, most of the day, the outside air temperature reaches values above 25 C; and natural ventilation can not remove the excess heat outside the greenhouse. Shade screens and whitewash are major existing measures used to reduce the greenhouse air temperature during summer by reducing the solar radiation entering the greenhouse. However, the greenhouse air temperature is reduced with a cost in radiation reduction. In addition, due to high air temperature values outside the greenhouse, generally, these systems are not sufficient for extracting the excess energy during sunny summer days and therefore, other cooling methods, such as forced ventilation combined with evaporative cooling, are needed. Evaporative cooling by means of pad and fan or fog systems is a common technique to reduce sensible heat load by increasing the latent heat fraction of dissipated energy. In most of the cases, the greenhouse growers, when all the above systems are available, apply both shading and evaporative cooling. If a movable screen is available, then the screen is usually activated when a certain radiation level is reached. It is not clear whether the shading screens should be used over the growth cycle or only during the most sensitive stages when the crops had a low leaf area and the canopy transpiration rate cannot significantly contribute to the greenhouse cooling. Furthermore, it is not clear which is the optimum radiation level that screen must be activated. This work aims to present the microclimate and cucumber crop physiological response and yield observed in two greenhouse compartments equipped with a pad and fan evaporative cooling system and a thermal/shading screen that is activated at different radiation levels: when the outside solar radiation reaches 700 or 900 W/m2. The greenhouse is located in Velestino, in Central Greece and the measurements are performed during the spring -summer period with the outside air temperature during summer reaching values up to 42C.

Keywords: microclimate, shading, screen, pad and fan, cooling

Procedia PDF Downloads 54
5008 A Case Study on Machine Learning-Based Project Performance Forecasting for an Urban Road Reconstruction Project

Authors: Soheila Sadeghi

Abstract:

In construction projects, predicting project performance metrics accurately is essential for effective management and successful delivery. However, conventional methods often depend on fixed baseline plans, disregarding the evolving nature of project progress and external influences. To address this issue, we introduce a distinct approach based on machine learning to forecast key performance indicators, such as cost variance and earned value, for each Work Breakdown Structure (WBS) category within an urban road reconstruction project. Our proposed model leverages time series forecasting techniques, namely Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory (LSTM) networks, to predict future performance by analyzing historical data and project progress. Additionally, the model incorporates external factors, including weather patterns and resource availability, as features to improve forecast accuracy. By harnessing the predictive capabilities of machine learning, our performance forecasting model enables project managers to proactively identify potential deviations from the baseline plan and take timely corrective measures. To validate the effectiveness of the proposed approach, we conduct a case study on an urban road reconstruction project, comparing the model's predictions with actual project performance data. The outcomes of this research contribute to the advancement of project management practices in the construction industry by providing a data-driven solution for enhancing project performance monitoring and control.

Keywords: project performance forecasting, machine learning, time series forecasting, cost variance, schedule variance, earned value management

Procedia PDF Downloads 21
5007 Emotional Intelligence and Sports Coaches

Authors: Stephens Oluyemi Adetunji, Nel Norma Margaret, Krogs Sozein

Abstract:

There has been a shift in the role of sports from being a form of entertainment and relaxation to becoming a huge business concern and high money spinning venture. This shift has placed a greater demand on sport coaches as regards expectations for high performance from investors as well as other stake holders. The responsibility of sports coaches in ensuring high performance of sports men and women has become increasingly more demanding from both spectators and sports organisers. Coaches are leaders who should possess soft skills such as emotional intelligence aside from employing skills and drills to ensure high performance of athletes. This study is, therefore, designed to determine the emotional intelligence of sports coaches in South Africa. An assessment of the emotional intelligence of sports coaches would enable the researchers to identify those who have low emotional intelligence and to design an intervention program that could improve their emotional intelligence. This study will adopt the pragmatic world view of research using the mixed methods research design of the quantitative and qualitative approach. The non-probability sampling technique will be used to select fifty sports coaches for the quantitative study while fifteen sports coaches will be purposively selected for the qualitative study. One research question which seeks to ascertain the level of emotional intelligence of sports coaches will be raised to guide this study. In addition, two research hypotheses stating that there will be no significant difference in the level of emotional intelligence of sports coaches on the basis of gender and type of sports will be formulated and statistically analysed at 0.05 level of significance. For the quantitative study, an emotional intelligence test will be used to measure the emotional intelligence of sport coaches. Focus group interviews and open ended questions will be used to obtain the qualitative data. Quantitative data obtained will be statistically analysed using the SPSS version 22.0 while the qualitative data will be analysed using atlas ti. Based on the findings of this study, recommendations will be made.

Keywords: emotional intelligence, high performance, sports coaches, South Africa

Procedia PDF Downloads 437
5006 Maternal Health Care Utilization and Its Effect on Pregnancy Outcome in Nepal

Authors: Adrita Banerjee, Ajeet Kumar Singh

Abstract:

Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

Procedia PDF Downloads 225
5005 School-Based Oral Assessment in Malaysian Schools

Authors: Sedigheh Abbasnasab Sardareh

Abstract:

The current study investigates ESL teachers' voices in order to formulate further research on the effectiveness of the SBOA practices. It is an attempt to find out (1) what are ESL experienced teachers’ perceptions, experiences, attitudes, and beliefs of SBOA; (2) what teaching and learning aspects of SBOA needs focus to enhance its effectiveness; (3) external issues related to the implementation of SBOA; (4) internal issues related to the implementation of SBOA; and also (5) perceived recommendations on SBOA. The study utilized focus group discussion sessions. 9 experienced ESL (5 females and 4 males) teachers were selected based on the consent letters sent to them. These teachers had over 20 years experience in both traditional and SBOA-type assessment and the train-the-trainer experts recommended by the Ministry of Education. Respondents were guided with open-ended questions to extracts their perceived experiences implementing SBOA guided structurally by the author as the moderator. Data were first discussed with the respondents for further clarifications and then only analyzed and re-confirmed with some recommendations before the final presentation of this preliminary results were presented here. The focus group discussions yielded some important perceived views on the SBOA implementation. Some of the themes were discussed and some recommendations were proposed for further in-depth study by the Ministry of Education. Some of the future directions based on the results were also put forward. Some external and internal variables were important in order for successful implementation of SBOA. Mere implementing a policy should be taken into consideration because this might impede some of the teaching and learning processes both by the classroom stakeholders such as teachers and student. More research methods such as the use of questionnaires could be utilized to further investigate to large populations of teacher educators in Malaysia.

Keywords: school based oral assessment, Malaysia, ESL, focus group discussion

Procedia PDF Downloads 319
5004 p210 BCR-ABL1 CML with CMML Clones: A Rare Presentation

Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

Abstract:

Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

Procedia PDF Downloads 63
5003 Patterns of Problem Behavior of Out-Of-School Adolescents and Gender Difference in South Korea

Authors: Jaeyoung Lee, Minji Je

Abstract:

Objectives: The adolescents not attending school are named out-of-school adolescents. They are more vulnerable to health management and are likely to be exposed to a number of risk factors. This study was conducted to investigate the problem behavior of out-of-school adolescents and analyze the difference caused by gender. Methods: In this study, the problem behaviors of out-of-school adolescents, the vulnerable class, were defined in 8 types and based on this definition, the survey on run away from home, drop out, prostitution, violence, internet game addiction, theft, drug addiction, and smoking was conducted. The study was conducted in a total of 507 out-of-school adolescents, including 342 males, and 165 females. The type, frequency and start time of the 8 problem behaviors were identified. The collected data were analyzed with chi-square test and t-test using SPSS statistics 22. Results: Among the problem behaviors of the subjects, violence ( =17.41, p < .001), internet game addiction ( =16.14, p < .001), theft ( =22.48, p < .001), drug addiction ( =4.17, p=.041), and smoking ( =3.90, p=.048) were more significantly high in male out-of-school adolescents than female out-of-school adolescents. In addition, the frequency of the problem behavior was higher in male out-of-school adolescents with statistical significance than in female out-of-school adolescents (t=5.08, p= < .001). In terms of the start time of the problem behavior, only internet game addiction was higher in male out-of-school adolescents with the statistical significance than in female out-of-school adolescents ( =6.22, p=.032). No statistically significant difference was found in other problem behaviors (p > .05). Conclusions: In this study, it was found that gender difference in problem behaviors of out-of-school adolescents exists, and its frequency and difference of types were identified. When the social countermeasures were provided for those adolescents, a distinguished approach is required depending on the patterns of problem behavior and gender. When preparing policy alternatives and interventions for out-of-school adolescents, it is required to reflect the results of this study.

Keywords: addictive behavior, adolescent, gender, problem behavior

Procedia PDF Downloads 193
5002 Use of the Occupational Repetitive Action Method in Different Productive Sectors: A Literature Review 2007-2018

Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

Abstract:

Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

Procedia PDF Downloads 161
5001 Developing a Video Game (Historia’s Nightmare) and Finding Out if We Can Use It to Raise Social Awareness and Improve Learning

Authors: Hasibul Kabir, Samin Shahriar Tokey, Md. Tofazzal Hossain

Abstract:

One of the most necessary things in the present time is raising social awareness about global warming and climate change among the people. Though many types of mediums and techniques have been used to teach people about this global phenomenon, there are still more effective ways to reach people with useful information about global warming. As many traditional methods to teach people about global warming and climate change did not work well, video games were overdue. To learn how effective a video game can be in this regard, we developed a Video game, "Historia's Nightmare," that teaches people about Global warming and climate change. The game was designed to entertain people and give them an idea about the reasons and consequences of global warming and climate change while not being like traditional educational games. The game threw a mini quiz consisting of two MCQs based on the information shown in the game, where a gamer had to pass the quiz to reach the next level. We published the game on different platforms to let all types of people play and complete our experiment effectively. The game continuously communicated with our server to send data about gamers' performance. We observed the data, including the participants' performance, time spent, quiz score, and the in-game feedback on a regular basis, and finally came to a verdict. In our experiment, we have found that most participants positively accepted the game and learned something new. The participants who spent more on our game performed better in both quiz and the game. Our experiment's result demonstrates that video games can be a great way to teach people something, particularly to raise social awareness about global warming and climate change. It also demonstrates that the game can be a significant element in education and learning improvement.

Keywords: video game, global warming, social awareness, climate change, education, feedback

Procedia PDF Downloads 112
5000 Comparison of Cervical Length Using Transvaginal Ultrasonography and Bishop Score to Predict Succesful Induction

Authors: Lubena Achmad, Herman Kristanto, Julian Dewantiningrum

Abstract:

Background: The Bishop score is a standard method used to predict the success of induction. This examination tends to be subjective with high inter and intraobserver variability, so it was presumed to have a low predictive value in terms of the outcome of labor induction. Cervical length measurement using transvaginal ultrasound is considered to be more objective to assess the cervical length. Meanwhile, this examination is not a complicated procedure and less invasive than vaginal touché. Objective: To compare transvaginal ultrasound and Bishop score in predicting successful induction. Methods: This study was a prospective cohort study. One hundred and twenty women with singleton pregnancies undergoing induction of labor at 37 – 42 weeks and met inclusion and exclusion criteria were enrolled in this study. Cervical assessment by both transvaginal ultrasound and Bishop score were conducted prior induction. The success of labor induction was defined as an ability to achieve active phase ≤ 12 hours after induction. To figure out the best cut-off point of cervical length and Bishop score, receiver operating characteristic (ROC) curves were plotted. Logistic regression analysis was used to determine which factors best-predicted induction success. Results: This study showed significant differences in terms of age, premature rupture of the membrane, the Bishop score, cervical length and funneling as significant predictors of successful induction. Using ROC curves found that the best cut-off point for prediction of successful induction was 25.45 mm for cervical length and 3 for Bishop score. Logistic regression was performed and showed only premature rupture of membranes and cervical length ≤ 25.45 that significantly predicted the success of labor induction. By excluding premature rupture of the membrane as the indication of induction, cervical length less than 25.3 mm was a better predictor of successful induction. Conclusion: Compared to Bishop score, cervical length using transvaginal ultrasound was a better predictor of successful induction.

Keywords: Bishop Score, cervical length, induction, successful induction, transvaginal sonography

Procedia PDF Downloads 313
4999 Maintaining Experimental Consistency in Geomechanical Studies of Methane Hydrate Bearing Soils

Authors: Lior Rake, Shmulik Pinkert

Abstract:

Methane hydrate has been found in significant quantities in soils offshore within continental margins and in permafrost within arctic regions where low temperature and high pressure are present. The mechanical parameters for geotechnical engineering are commonly evaluated in geomechanical laboratories adapted to simulate the environmental conditions of methane hydrate-bearing sediments (MHBS). Due to the complexity and high cost of natural MHBS sampling, most laboratory investigations are conducted on artificially formed samples. MHBS artificial samples can be formed using different hydrate formation methods in the laboratory, where methane gas and water are supplied into the soil pore space under the methane hydrate phase conditions. The most commonly used formation method is the excess gas method which is considered a relatively simple, time-saving, and repeatable testing method. However, there are several differences in the procedures and techniques used to produce the hydrate using the excess gas method. As a result of the difference between the test facilities and the experimental approaches that were carried out in previous studies, different measurement criteria and analyses were proposed for MHBS geomechanics. The lack of uniformity among the various experimental investigations may adversely impact the reliability of integrating different data sets for unified mechanical model development. In this work, we address some fundamental aspects relevant to reliable MHBS geomechanical investigations, such as hydrate homogeneity in the sample, the hydrate formation duration criterion, the hydrate-saturation evaluation method, and the effect of temperature measurement accuracy. Finally, a set of recommendations for repeatable and reliable MHBS formation will be suggested for future standardization of MHBS geomechanical investigation.

Keywords: experimental study, laboratory investigation, excess gas, hydrate formation, standardization, methane hydrate-bearing sediment

Procedia PDF Downloads 43
4998 25 (OH)D3 Level and Obesity Type, and Its Effect on Renal Excretory Function in Patients with a Functioning Transplant

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba, Marek Jan Kuzniewski

Abstract:

Introduction: Vitamin D3 has a proven pleiotropic effect, not only responsible for calcium and phosphate management, but also influencing normal functioning of the whole body. Aim: Evaluation of vitamin D3 resources and its effect on a nutritional status, obesity type and glomerular filtration in kidney transplant recipients. Methods: Group of 152 (81 women and 71 men, average age 47.8 ± 11.6 years) patients with a functioning renal transplant their body composition was assessed using the bioimpendance method (BIA) and anthropometric measurements more than 3 months after the transplant. The nutritional status and the obesity type were determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). 25- Hydroxyvitamin D3 (25 (OH)D3) was determined, together with its correlation with the obesity type and the glomerular filtration rate (eGFR) calculated with the MDRD formula. Results: The mean 25 (OH)D3 level was 20.4 ng/ml. 30ng/ml was considered as a minimum correct level 22,7% of patients from the study group were classified to be a correct body weight, 56,7% of participants had an android type and 20,6% had a gynoid type. Significant correlation was observed between 25 (OH)D3 deficiency and abdominal obesity (p < 0.005) in patients. Furthermore, a statistically significant relationship was demonstrated between the 25 (OH)D3 levels and eGFR in patients after a kidney transplant. Patients with an android body type had lower eGFR versus those with the gynoid body type (p=0.004). Conclusions: Correct diet in patients after a kidney transplant determines minimum recommended serum levels of vitamin D3. Excessive fatty tissue, low levels of 25 (OH)D3), may be a predictor for android obesity and renal injury; therefore, correct diet and pharmacological management together with physical activities adapted to the physical fitness level of a patient are necessary.

Keywords: kidney transplantation, glomerular filtration rate, obesity, vitamin D3

Procedia PDF Downloads 265
4997 Ventriculo-Gallbladder Shunt: Case Series and Literature Review

Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

Abstract:

BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

Procedia PDF Downloads 57
4996 Shift in the Rhizosphere Soil Fungal Community Associated with Root Rot Infection of Plukenetia Volubilis Linneo Caused by Fusarium and Rhizopus Species

Authors: Constantine Uwaremwe, Wenjie Bao, Bachir Goudia Daoura, Sandhya Mishra, Xianxian Zhang, Lingjie Shen, Shangwen Xia, Xiaodong Yang

Abstract:

Background: Plukenetia volubilis Linneo is an oleaginous plant belonging to the family Euphorbiaceae. Due to its seeds containing a high content of edible oil and rich in vitamins, P. volubilis is cultivated as an economical plant worldwide. However, the cultivation and growth of P. volubilis is challenged by phytopathogen invasion leading to production loss. Methods: In the current study, we tested the pathogenicity of fungal pathogens isolated from root rot infected P. volubilis plant tissues by inoculating them into healthy P. volubilis seedlings. Metagenomic sequencing was used to assess the shift in the fungal community of P. volubilis rhizosphere soil after root rot infection. Results: Four Fusarium isolates and two Rhizopus isolates were found to be root rot causative agents of P. volubilis as they induced typical root rot symptoms in healthy seedlings. The metagenomic sequencing data showed that root rot infection altered the rhizosphere fungal community. In root rot infected soil, the richness and diversity indices increased or decreased depending on pathogens. The four most abundant phyla across all samples were Ascomycota, Glomeromycota, Basidiomycota, and Mortierellomycota. In infected soil, the relative abundance of each phylum increased or decreased depending on the pathogen and functional taxonomic classification. Conclusions: Based on our results, we concluded that Fusarium and Rhizopus species cause root rot infection of P. volubilis. In root rot infected P. volubilis, the shift in the rhizosphere fungal community was pathogen-dependent. These findings may serve as a key point for a future study on the biocontrol of root rot of P. volubilis.

Keywords: fusarium spp., plukenetia volubilis l., rhizopus spp., rhizosphere fungal community, root rot

Procedia PDF Downloads 10
4995 Azaridachta indica (Neem) Seed Oil Effect in Experimental Arthritis: Biochemical Parameters Assessment

Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

Abstract:

Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Due to the presence of bioactive substances such as nimbolide, azadirachtin, and gedunin, Neem offers a variety of medicinal properties, including anti-inflammatory and antioxidant properties. Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied, and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1, and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was the most effective of all therapies investigated. Acknowledgement: SAIA PROJECT of Kevine Kamga Silihe, Slovakia-Cameroon 2023: “The effect of Crocus sativus L (Saffron), Azadirachta indica (Neem) and their main bioactives compounds in combinatory treatment with methotrexate on experimental arthritis”, VEGA 2/0079/24, VEGA 2/0136/20, VEGA 2/0126/23 and VEGA 2/0091/23.

Keywords: adjuvant, Neem, methotrexate, arthritis

Procedia PDF Downloads 21
4994 Osteoarticular Ultrasound for Diagnostic Purposes in the Practice of the Rheumatologist

Authors: A. Ibovi Mouondayi, S. Zaher, K. Nassar, S. Janani

Abstract:

Introduction: Osteoarticular ultrasound has become an essential tool for the investigation and monitoring of osteoarticular pathologies for rheumatologists. It is performed in the clinic, cheap to access than other imaging technics. Important anatomical sites of inflammation in inflammatory diseases such as synovium, tendon sheath, and enthesis are easily identifiable on ultrasound. Objective: The objective of this study was to evaluate the importance of ultrasound for rheumatologists in the development of diagnoses of inflammatory rheumatism in cases of uncertain clinical presentation. Material and Methods: This is a retrospective study conducted in our department and carried out over a period of 30 months from January 2020 to June 2022. We included all patients with inflammatory arthralgia without clinical arthritis. Patients' data were collected through a patient operating system. Results: A total of 35 patients were identified, made up of 4 men and 31 women, with a sex ratio M/F of 0.12. The average age of the patients was 48.8 years, with extremes ranging from 17 years to 83 years. All patients had inflammatory polyarthralgia for an average of 9.3 years. Only two patients had suspicious synovitis on clinical examination. 91.43% of patients had a positive inflammatory assessment with an average CRP of 22.2 mg/L. Rheumatoid factor (RF) was present in 45.7% of patients and anti-CCP in 48.57%, with respective averages of 294.43 and 314.63 international units/mL. Radiographic lesions were found in 54% of patients. Osteoarticular ultrasound was performed in all these patients. Subclinical synovitis was found in 60% of patients, including 23% Doppler positive. Tenosynovitis was found in 11% of patients. Enthesitis was objectified in 3% of patients. Rheumatoid arthritis (RA) was retained in 40% of patients; psoriatic arthritis in 6% of patients, hydroxyapatite arthritis, and osteoarthritis in 3% each. Conclusion: Osteoarticular ultrasound has been an essential tool in the practice of rheumatology in recent years. It is for diagnostic purposes in chronic inflammatory rheumatism as well as in degenerative rheumatism and crystal induced arthropathies, but also essential in the follow-up of patients in rheumatology.

Keywords: ultrasound, skeletal, rheumatoid arthritis, arthralgia

Procedia PDF Downloads 102
4993 Optimization of Samarium Extraction via Nanofluid-Based Emulsion Liquid Membrane Using Cyanex 272 as Mobile Carrier

Authors: Maliheh Raji, Hossein Abolghasemi, Jaber Safdari, Ali Kargari

Abstract:

Samarium as a rare-earth element is playing a growing important role in high technology. Traditional methods for extraction of rare earth metals such as ion exchange and solvent extraction have disadvantages of high investment and high energy consumption. Emulsion liquid membrane (ELM) as an improved solvent extraction technique is an effective transport method for separation of various compounds from aqueous solutions. In this work, the extraction of samarium from aqueous solutions by ELM was investigated using response surface methodology (RSM). The organic membrane phase of the ELM was a nanofluid consisted of multiwalled carbon nanotubes (MWCNT), Span80 as surfactant, Cyanex 272 as mobile carrier, and kerosene as base fluid. 1 M nitric acid solution was used as internal aqueous phase. The effects of the important process parameters on samarium extraction were investigated, and the values of these parameters were optimized using the Central Composition Design (CCD) of RSM. These parameters were the concentration of MWCNT in nanofluid, the carrier concentration, and the volume ratio of organic membrane phase to internal phase (Roi). The three-dimensional (3D) response surfaces of samarium extraction efficiency were obtained to visualize the individual and interactive effects of the process variables. A regression model for % extraction was developed, and its adequacy was evaluated. The result shows that % extraction improves by using MWCNT nanofluid in organic membrane phase and extraction efficiency of 98.92% can be achieved under the optimum conditions. In addition, demulsification was successfully performed and the recycled membrane phase was proved to be effective in the optimum condition.

Keywords: Cyanex 272, emulsion liquid membrane, MWCNT nanofluid, response surface methology, Samarium

Procedia PDF Downloads 409
4992 Use of Locally Available Organic Resources for Soil Fertility Improvement on Farmers Yield in the Eastern and Greater Accra Regions of Ghana

Authors: Ebenezer Amoquandoh, Daniel Bruce Sarpong, Godfred K. Ofosu-Budu, Andreas Fliessbach

Abstract:

Soil quality is at stake globally, but under tropical conditions, the loss of soil fertility may be existential. The current rates of soil nutrient depletion, erosion and environmental degradation in most of Africa’s farmland urgently require methods for soil fertility restoration through affordable agricultural management techniques. The study assessed the effects of locally available organic resources to improve soil fertility, crop yield and profitability compared to business as usual on farms in the Eastern and Greater Accra regions of Ghana. Apart from this, we analyzed the change of farmers’ perceptions and knowledge upon the experience with the new techniques; the effect of using locally available organic resource on farmers’ yield and determined the factors influencing the profitability of farming. Using the Difference in Mean Score and Proportion to estimate the extent to which farmers’ perceptions, knowledge and practices have changed, the study showed that farmers’ perception, knowledge and practice on the use of locally available organic resources have changed significantly. This paves way for the sustainable use of locally available organic resource for soil fertility improvement. The Propensity Score Matching technique and Endogenous Switching Regression model used showed that using locally available organic resources have the potential to increase crop yield. It was also observed that using the Profit Margin, Net Farm Income and Return on Investment analysis, it is more profitable to use locally available organic resources than other soil fertility amendments techniques studied. The results further showed that socioeconomic, farm characteristics and institutional factors are significant in influencing farmers’ decision to use locally available organic resources and profitability.

Keywords: soil fertility, locally available organic resources, perception, profitability, sustainability

Procedia PDF Downloads 131
4991 Combined Cervical Headache Snag with Cervical Snag Half Rotation Techniques on Cervicogenic Headache Patients

Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

Abstract:

Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

Procedia PDF Downloads 179
4990 The Effect of a New Reimbursement Policy for Discharge Planning Service

Authors: Chueh Chi-An, Chan Hui-Ya

Abstract:

Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

Procedia PDF Downloads 162
4989 Computational Screening of Secretory Proteins with Brain-Specific Expression in Glioblastoma Multiforme

Authors: Sumera, Sanila Amber, Fatima Javed Mirza, Amjad Ali, Saadia Zahid

Abstract:

Glioblastoma multiforme (GBM) is a widely spread and fatal primary brain tumor with an increased risk of relapse in spite of aggressive treatment. The current procedures for GBM diagnosis include invasive procedures i.e. resection or biopsy, to acquire tumor mass. Implementation of negligibly invasive tests as a potential diagnostic technique and biofluid-based monitoring of GBM stresses on discovering biomarkers in CSF and blood. Therefore, we performed a comprehensive in silico analysis to identify potential circulating biomarkers for GBM. Initially, six gene and protein databases were utilized to mine brain-specific proteins. The resulting proteins were filtered using a channel of five tools to predict the secretory proteins. Subsequently, the expression profile of the secreted proteins was verified in the brain and blood using two databases. Additional verification of the resulting proteins was done using Plasma Proteome Database (PPD) to confirm their presence in blood. The final set of proteins was searched in literature for their relationship with GBM, keeping a special emphasis on secretome proteome. 2145 proteins were firstly mined as brain-specific, out of which 69 proteins were identified as secretory in nature. Verification of expression profile in brain and blood eliminated 58 proteins from the 69 proteins, providing a final list of 11 proteins. Further verification of these 11 proteins further eliminated 2 proteins, giving a final set of nine secretory proteins i.e. OPCML, NPTX1, LGI1, CNTN2, LY6H, SLIT1, CREG2, GDF1 and SERPINI1. Out of these 9 proteins, 7 were found to be linked to GBM, whereas 2 proteins are not investigated in GBM so far. We propose that these secretory proteins can serve as potential circulating biomarker signatures of GBM and will facilitate the development of minimally invasive diagnostic methods and novel therapeutic interventions for GBM.

Keywords: glioblastoma multiforme, secretory proteins, brain secretome, biomarkers

Procedia PDF Downloads 138